This proposal concerns long-term effects of prenatal exposure to alcohol on children ages 5-6. A 1978-79 survey of obstetric patients representing a broad range of socioeconomic levels found a high rate of heavy drinking in early pregnancy without recognizable effects on the neonates. Yet study of the fetal alsochol syndrome strongly suggests that in utero alcohol exposure may produce cognitve and behavioral impairment in the absence of apparent fetal alcohol effects. It is proposed to conduct a longitudinal follow-up of these neonates to determine whether children exposed to alcohol in utero, but who do not have obvious fetal alcohol effects, display subtle, hitherto unrecognized, impairments of cognition and behavior. Offspring of women who were abstainers, light drinkers, or heavy drinkers in the month prior to recognition of pregnancy, will be compared on cognitive and behavioral measures. Each group is projected to have about 50 subjects. Children will be examined individually on the following cognitive dimensions: IQ; visual-motor integration; receptive language function; and hemispheric lateralization for perception of linguistic and non-linguistic sounds (dichotic listening). Behavior will be evaluated by parental report on a questionnaire survey of childhool psychopathology and on a questionnaire specifically for hyperactivity. Hyperactivity will be evaluated further by parental interview concerning infant, toddler, and current hyperactive behavior. Ability to inhibit motor activity will be assessed by direct examination. Subjects will also be examined for age-specific height and weight and for external dysmorphic features. Possibly confounding factors will be controlled by matching subjects on maternal and sociodemographic variables and by adjusting for any between group differences in postnatal health, environment, and family health history prior to testting the significance of group differences in cognitve and behavioral measures. Long-term goals are directed toward definition of subtle adverse effects of in utero alcohol exposure and practical methods for detecting them in order to improve prevention and treatment.